211例下肢长骨骨折带锁髓内钉固定的临床评价

211 cases of long bone shaft fracture at lower limbs treated with intramedullary interlocking nails

目的对211例下肢长骨骨折带锁髓内钉内固定治疗的临床结果进行评价。方法用不扩髓带锁髓内钉为主要固定方法,对211例股骨、胫骨骨折进行手术复位内固定治疗,术后进行包括CPM在内的有序功能锻炼。结果获得随访189例,时间4～26个月,平均9个月。全组病例获得骨性愈合,无骨不连发生,骨折延迟愈合7例,膝关节功能受限4例。按Johner-wruch标准:优158例,良22例,中9例,优良率95.2%。结论带锁髓内钉是治疗下肢长骨骨折较好的方法,其适应证较以往有进一步的拓展,术中骨折复位与保存骨折块血供并重的理念是正确的。

Objective To assess the clinical results of the treatment of the 211 cases of long bone shaft fractures at lower limbs with intramedullary interlocking nails. Methods 211 cases of femoral and tibial fractures were treated chiefly with unreamed intramedullary interlocking nails and postoperative functional exercises including continuous passive motion (CPM). Results 189 cases were followed up for an average of 9 months (ranging from 4 to 26 months). All the cases achieved bone union, and no nonunion occurred. Delayed union occurred in 7 cases and limited knee joint function in 4 cases. According to the Johner-wruhs criteria, 178 cases were assessed as excellent, 24 as good and 9 as fair. The total excellent and good rate was 95.6%. Conclusions The intramedullary interlocking nail is a good device for the treatment of long bone shaft fractures at lower limbs. Its indications have become wider. It is correct to pay equal attention to the blood supply of the fractured bone and the reduction of the fracture during the operation.